| NPI | 1922109206 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DE C50000438) | 
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C03083) | 
| Enumeration Date | 2006-09-26 | 
| Last Update Date | 2008-08-06 |